Mouhamed Iyad Fakhri, MD, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

200301225 Issued in NC

Legal business name

MOUHAMED IYAD FAKHRI, MD, PA

Practice address

620 College Street
Clinton, NC 28328

Phone

(910) 590-0009

Fax

(910) 590-2465

NPI assigned

Aug 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mouhamed Iyad Fakhri, MD

Title

Owner

Phone

(910) 590-0009

Specialties & licenses 1

Addresses

Other identifiers 3

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1861500506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 COLLEGE STREET",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "28328",
            "telephone_number": "910-590-0009",
            "fax_number": "910-590-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 COLLEGE STREET",
            "city": "CLINTON",
            "state": "NC",
            "postal_code": "28328",
            "telephone_number": "910-590-0009",
            "fax_number": "910-590-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUHAMED IYAD FAKHRI, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "FAKHRI",
        "authorized_official_first_name": "MOUHAMED",
        "authorized_official_middle_name": "IYAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-590-0009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200301225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "187178",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891350K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1350K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Butler Montgomery, M.ED,CFY/SLP
• Wesley Dale Moore, D.C.
• Eskander G Morkos, MD
• Erica Morris
• Kevin Mote, RBT
• David R. Mullen, MSW., PH.D
• Maddison Nancarrow
• National Mentor Healthcare, LLC
• Cherish Tart Naylor, PHARMD
• Peter Wahida Nemr, LCMHC-A

• Internal Medicine Physician in Clinton, NC
• Providers in Clinton, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.